Glaucoma ; diagnosis ; therapy ; Humans ; Research

PURPOSE: To evaluate and compare the characteristics of patients whose nerve fiber layer (NFL) photographs showing diffuse or focal nerve fiber layer defects. METHODS: Patients with diffuse NFL defect were selected by comparing upper and lower half of a NFL photo, and we included the patients only when one part of it showed NFL defect. Patients with focal NFL defect were selected only when one eye had a wedge-shape NFL defect. RESULTS: There were no significant differences between the two groups in visual field index, nor in the results of glaucoma hemifield test. However, patients with diffuse NFL defect (13 eyes, 13 patients) mostly had primary open-angle glaucoma (POAG) (62%), and patients with focal NFL defect (13 eyes, 13 patients) mostly had normal- tension glaucoma (NTG) (62%) (p=0.048, chi-square test). CONCLUSIONS: We found significant differences in the diagnosis of glaucoma between the diffuse and focal NFL loss groups. Our results suggest that the characteristics of NFL loss in POAG and NTG may be different.
Diagnosis ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Nerve Fibers* ; Visual Fields

The method of observation for quantitative evaluation of disc pattern in early diagnosis of simple glaucoma was discussed in view of necessity of quantitative analysis of disc pattern, outline of quantitative disc pattern, judgement of quantitative disc pattern, type of glaucomatous cupping and classification of grade for glaucoma etc. At this attempt, authors observed vertical cup and disc ratio of physiologic cupping, prior to the investigation of variations of glaucomatous changes of optic disc. The associated factors with this study were briefly mentioned for further study.
Classification ; Early Diagnosis* ; Evaluation Studies as Topic* ; Glaucoma ; Glaucoma, Open-Angle*

OBJECTIVE: In order to study the mechanism of the aqueous humor circulation and its relationship to the glaucoma macroscopically with engineering methods. METHODS: A dynamistic model was presented, which can be used to simulate the situation and the treatment of the primary open angle glaucoma (POAG). The frame of the model was built based on the ophthalmically accepted feedback mechanism between the aqueous humor circulation and the intraocular pressure (IOP). The transfer functions and the parameters were educed from the analysis of physiological theories, the basic elements of hydrodynamics, and the clinical parameters. The relation between the parameters of the system and the episode mechanism of POAG was discussed. A digital method was used to simulate the Challenge test and some medicines' treatment of POAG, and the results were consistent with clinical observations. RESULTS: The results of simulation illuminate that the model can simulate the mechanism of the aqueous humor circulation and the curative mechanism of some medicines under the physiological condition and the pathological condition of the POAG. CONCLUSION: A few parameters which can hardly be captured with clinical method could be obtained from the model. These parameters can be helpful for the diagnosis and prediction of the curative effect.
Aqueous Humor* ; Diagnosis ; Glaucoma ; Glaucoma, Open-Angle* ; Hydrodynamics ; Intraocular Pressure

The Humphrey Visual Field Analyzer and The Octopus Visual Field Analyzer in Early Primary Open Angle Glaucoma Visual field measurements are useful tool not only for diagnosis but also for management ealuation of early glaucoma. To know the relationship between the results of visual field which were performed by the Humphrey and the Octopus, the 25 disc data which have shown the general reduction of sensitivity on two continuous separate sessions in Humphrey viual field analyzer were transmitted into the Peridata Standard Printout Mode of GIX program on the Octopus 1-2-3. We compared the aspect of Bebie curve of Octopus 1-2-3 and the difference of the global indices between Humphrey and Octopus in the basically input data of age related standard sensitivity of visual field. The general reduction of sensitivity in Humphrey visual field analyzer showed the sensitivity loss in Bebie curve of Octopus 1-2-3(p<5%). In the statistical analysis of Global indices between the two field analyzers there were no differences in the MD and PSD(p>0.05) but were difference the CPSD and SF(p<0.05). In the comparison of the correlation on global indices between the two field analysis. MD and PSD were closely correlated r=0.657, PSD r=0.697, p<0.001), CPSD and SF were statistically correlated(p<0.001) but had lower correlation coefficients(CPSD r=0.478, SF r=0.389). Thus we conclude that there are little differences between the results of two field analyzers.
Diagnosis ; Glaucoma ; Glaucoma, Open-Angle* ; Octopodiformes* ; Visual Fields*

PURPOSE: To evaluate the ability of qualitative signs for glaucoma diagnosis, both alone and in combination, to discriminate between eyes with and without glaucomatous visual field damage. Furthermore, we investigated whether the characteristic optic disc changes in primary angle-closure glaucoma (PACG) differ from those in primary open-angle glaucoma (POAG). METHODS: Using color polaroid optic disc photographs, we examined 10 qualitative signs in 177 patients with PACG, 184 patients with POAG, and 181 normal subjects. RESULTS: Rim notches and rim shape alteration were found more frequently in patients with POAG than in those with PACG (p<0.05). Disc hemorrhage was not found in any eye in the PACG group. In the early stage (mean deviation >-6 dB) of the PACG and POAG groups, the best qualitative sign was rim shape alteration, and area under the receiver operating characteristic (ROC) curve was 0.696 and 0.768, respectively. The area under the ROC curve for the combination of qualitative signs was 0.802 and 0.918, respectively. CONCLUSIONS: These results suggest that glaucomatous disc damage was less pronounced in the PACG eyes than in the POAG eyes with similar visual field damage. A combination of the qualitative signs of optic disc using multiple logistic regression modelling improved the diagnostic ability.
Diagnosis ; Glaucoma ; Glaucoma, Angle-Closure* ; Glaucoma, Open-Angle* ; Hemorrhage ; Humans ; Logistic Models ; ROC Curve ; Visual Fields

Objective: In previous decades, glaucoma has been primarily attributed to elevated intraocular pressure (IOP), but this has gradually been replaced by the development of optic neuropathy as the central concept of glaucoma in developed countries. However, there still remain strong controversies in the definition of glaucoma in China. In this current review, we are going to discuss these controversies and elaborate on the historical transitions of the definition of glaucoma both in China and developed countries. Furthermore, we will briefly describe the "ocular-cranial pressure gradient" theory and discuss the relationship between glaucoma and degenerative diseases of the central nervous system (CNS) in order to show the complex pathogenesis of glaucoma and the importance for the modification to the definition of glaucoma. Data Sources: We performed a comprehensive search in both PubMed and SinoMed using the following keywords: (a) "primary glaucoma" and "guideline," (b) "ocular-cranial pressure gradient," and (c) "glaucoma," "Alzheimer's disease," and "Parkinson's disease." The literature search included the related articles with no restrictions on publication date. Study Selection: The primary references were Chinese and English articles including (a) original guidelines and expert consensuses of primary glaucoma, (b) reviews focusing on the differences between various versions of these guidelines and consensuses, and (c) papers about ocular-cranial pressure gradient theory and the relationship between glaucoma and CNS degenerative diseases. Results: The definitions and classifications of both primary open-angle glaucoma and primary angle-closure glaucoma differ between Chinese glaucoma consensuses and international primary glaucoma guidelines. Chinese definitions and classifications put more emphasis on the IOP, while international guidelines put more emphasis on the presence of optic neuropathy. The ocular-cranial pressure gradient theory and the research on the relationship between glaucoma and CNS degenerative diseases have provided new directions for exploring the pathogenesis of glaucoma. Conclusions As regards the definition and classification of primary glaucoma, we find that there are still some discrepancies between Chinese expert consensuses and international guidelines. Glaucoma is a disease with complex etiologies, while its common characteristic is a specific optic neuropathy. The current definition and understanding of glaucoma is an ongoing and evolving process, reflecting our latest available evidence on its pathogenesis. Chinese ophthalmology community may need to update our guidelines, accommodating these latest developments.
China ; Glaucoma ; diagnosis ; physiopathology ; Glaucoma, Angle-Closure ; diagnosis ; physiopathology ; Glaucoma, Open-Angle ; diagnosis ; physiopathology ; Humans ; Intraocular Pressure ; physiology ; Ophthalmology ; methods

This study analyzed various aspects of what glaucoma patients think about their quality of life(QOL), knowledge of glaucoma, and compliance to treatment. For the study, survey and multifactorial analysis were performed in 165 patients in 10 subject with 60 questions. After the diagnosis of glaucoma, 25.5% of patients were not satisfied with their life compared with 7.3% of them before the diagnosis. Life satisfaction could be decreased from 3.76 point in Likert scale before the diagnosis to 3.07 point after the diagnosis. Life satisfaction decreased significantly in the highly educated group, in the upper or lower income group, and in those who thought as though they were generally healthy. Beside these results, 87.3% of patients were afraid of losing their vision, 78.2% of the patients who had not been operated preferred medical treatment to surgery.
Compliance ; Diagnosis ; Glaucoma* ; Humans ; Quality of Life*

The measurement of the area of the optic disc is important to classification of congenital anomaly of optic disc and diagnosis and following up of glaucoma. This study was performed to measure easily the diameter and area of the optic disc using the retinal scale of the Volk lens although recently the study was reported to measure the optic disc with computerized optic disc analysis system. We evaluated the measurement of the diameter and area of the optic disc of 31 patients(56 eyes) using the retinal scale of Volk lens and then corrected the magnification of central fundus photographs using Litmann's method. The mean refractive power and the mean axial length was -0.24 diopter(range -4.5 to 4.25 diopter), and 22.91 mm (range 20.5 to 26.1mm), respectively. The mean horizontal diameter, the mean verticaI diameter, and the mean area of optic disc was 1.75 +/- 0.18mm, 1.90 +/- 0.19mm, and 2.62 +/- 0.50mm2, respectively. We think that the measurement of the optic disc area with Volk lens is useful method in following up of cup-disc ratio in outpatient basis.
Classification ; Diagnosis ; Glaucoma ; Humans ; Outpatients ; Retinaldehyde

Many visual field indices have been used for the rapid, precise evaluation of the Humphrey automated visual field. The clinical usefulness of Pericecal Index(PI), the mean sensitivity of 11 test points around the blind spot, was studied in the diagnosis of early glaucoma. PI was calculated in 60 eyes with low tension glaucoma(LTG)[mean defect<10dB], 60 eyes with early visual field change[general reduction of sensitivity(GRS)] and in 60 normal eyes. The difference between glaucomatolls eyes and normal eyes was statistically significant(p<0.01). And also compared PI with the mean sensitivity of 11 control points, located at same eccentricity in lower field and used this as the Control Area(CA). More over, the mean sensitivity of these points in glaucomatous and normal eyes was compared. The difference between PI and CI was only statistically significant in glaucomatolls eyes. On the other hand, We found a significant difference between normal and glaucomatolls control points. Thus we concluded that PI can be the useful visual field indix for the diagnosis of early glaucoma.
Diagnosis ; Glaucoma* ; Hand ; Optic Disk ; Visual Fields*